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Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION
Citystate Centre, 709 Shaw Boulevard, Pasig City
Call Center (02) 441-7442 Trunkline (02) 441-7444
www.philhealth.gov.ph
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PHILHEALTH CIRCULAR
No. 2017- _Q_O-"&Q__

TO ACCREDITED HEALTH CARE INSTITUTIONS, HEALTH CARE

INSTITUTION SERVICE BANKS AND ALL OTHERS CONCERNED

SUBJECT IMPLEMENTATION OF AUTO-CREDIT PAYMENT SCHEME

(ACPS) TO ALL HEALTH CARE INSTITUTIONS

L RATIONALE

Phi!Health Circular No. 043 series 2012 entitled "Reimbursement of Hospital Claims
through Auto-Credit Payment Scheme (ACPS)" became a pivotal component in
shortening the claims processing time thereby improving claims processing efficiency.
The ACPS is a mechanism whereby payment of the claims of health care institutions
(HCis) is credited directly through its designated deposit account with the partner
bank/ s. Although participation in ACPS was offered only, tq hospitals, and on an
optional basis, the remarkable experience gained from this process by both Health Care
Institutions (HCis) and Phi!Health has been encouraging enough for the latter to
consider strengthening its application through a wider involvement of HCis.

II. OBJECTIVE

This policy aims to improve claim process efficiency by automating Phi!Healtl1's payment
mechanism with the HCI's banking service providers. This shall guide HCis by
prescribing standard requirements for HCI autocredit registration, official receipt
information, and autocredit payment schedules.

III. SCOPE

The expanded ACPS shall cover all claims coming from HCis. The ACPS shall not
apply to member-filed claims.

IV. DEFINITION OF TERMS

A. Auto Credit Payment - is a payment scheme whereby settlement of HCI claim is

directly credited to their designated deposit accounts.

Real Time Gross Settlement (RTGS) - is a gross settlement system in which both
processing and final settlement of funds transfer instructions can take place
continuously (real time). As it is a gross settlement, transfers are settled individually
without netting debits against credits. An RTGS system can thus be characterized as
a funds transfer system that is able to provide continuous intraday finality for

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individual transfers provided that a sending bank has sufficient covering balances or
credit. 1

V. GENERAL GUIDELINES

A. All HCis shall be required to open deposit account/s with the local banks
authorized to do banking business in the Philippines under the supervision and
regulation of the Bangko Sentral ng Pilipinas, for the Phi!Health auto-credit
payment facility. The deposit account/ s shall be the destination account into which
reimbursements will be credited.

B. HCis already enrolled under the ACPS with LandBank shall opt to either retain their
existing account or open an account with their preferred servicing bank.

C. For non LandBank accounts the RTGS fee shall be paid by the HCI/LGU HCis. In
no instance shall Phi!Health pay the RTGS or any other transaction fees between banks.

D. All accredited HCis shall be required to be ACPS compliant upon effectivity of this
circular. Otherwise, payment release shall be put on hold and no checks shall be
issued to HCis for claims payments.

E. Phi!Health reimbursements shall be credited through ACPS every Wednesday of the

week or the next working day, in case crediting day falls on a non-working holiday.

F. HCis shall issue individual Official Receipts (ORs) for every Phi!Health
reimbursements credited/ paid to their deposit account/ s. The OR must indicate the
following details:

1. Name ofHCI (or Name ofLGU, as applicable)

2. Bank account name
For Government/LGU owned HCI, indicate if for HCI charges or Professional
fee designated for pooling
3. Bank account number
4. Benefit Disbursement Voucher Number
5. Net amount received
6. Credit date
7. If OR is not printed from Point of Sale, signature in the OR shall be required

It shall ensure that the ORs are received by Phi!Health within fifteen (15) calendar
days after the corresponding credit date.

Sample Illustration for JUNE 2017:

1
Source: page 26 ofhttp://www.bsp.gov.ph/downloads/publications/2003/BSR2003_03.pdf

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G. HCis that fail to issue and deliver OR on or before the deadline shall not receive
reimbursements on the credit date after the fifteenth (1S"')day.

H. In case a valid problem arises that prevents or delays payments through the ACPS
or with an ACPS account of a HCI, Phi!Health may temporarily revert back to
check issuance, but only up to such time that the issue has been resolved. Phi!Health
shall duly notify the concerned HCis in cases of such occurrence.

I. The reimbursements of HCI claims shall be governed by relevant policies on

benefits, monitoring and other pertinent issuances ofPhi!Health.

J. The HCI shall be subjected to the applicable banking rules and regulations of their
partner bank.

VI. SPECIFIC GUIDELINES

A. The following are the required deposit account/ s that shall be opened and
maintained with the partner bank/ s:

1. Private HCis - one (1) deposit account only, exclusively for Phi!Health
reimbursements. It shall bear the account name: '(Name of HCI) for HCI
Charges'

2. Government HCis - two (2) deposit accounts as trust funds

a) '(Name ofHCI) for HCI Charges'
b) '(Name ofHCI) for Professional Fee designated for Pooling'

Local Government Units (LGU) shall opt to open and maintain one (1) account for
the HCI charges and one (1) account for professional fee designated for pooling for
all HCis under the LGU's jurisdiction. Bank accounts shall be treated as trust fund.
a. '(Name ofLGU) for HCI Charges'
b. '(Name of LGU) for Professional Fee designated for Pooling'

However, the LGU shall maintain a subsidiary ledger for the account receivables
from Phi!Health for each of the HCI.

B. The HCI shall submit to its respective Phi!Health Regional office (PRO) upon
opening of the bank account/ s, the following:

1. Duly filled-out and signed Notice of ACPS Compliance- Annex A, B, and C for
private, government and LGU owned HCI, respectively.

2. Bank Certification, duly signed by the Branch Manager, from where the deposit
account is opened. (sample in Annex D)
...
C. HCI shall be emailed by the respective PRO their respective bank information, to
.~ which the former shall reply to affirm correctness of details. Auto credit shall only
~ commence upon confirmation of the registered bank account.

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D. HCis with existing bank accounts with their preferred partner bank need not open a
new deposit account as long as item V.A is fulfilled.

E. Phi!Health shall issue an Auto - Credit Payment Notice (ACPN) containing the
details/breakdown of the paid claims. The HCI and LGU may use the ACPN to
reconcile paid claims against their transmitted claims.

F. The HCI shall be responsible for acquiring a copy of the ACPN from the respective
PRO orLHIO.

VII. SERVICE PROVIDERS FOR ACPS

A. LandBank shall be the primary service provider for ACPS.

B. In case HCI opts to replace their ACPS servicing bank, they shall notify Phi!Health
fifteen (15) days before effectivity of the account. HCI shall submit a Notice of
Change of Bank Account for ACPS (Annex E, F, and G for private, government,
and LGU- owned HCI, respectively)

VIII. REPEALING CLAUSE

This shall amend Phi!Health Circular no. 43 s, 2012 and other related issuances that are
inconsistent with this Circular.

IX. EFFECTIVITY

This Circular shall take effect on September 1, 2017 after publication in the Official
Gazette and /or any newspaper of general circulation, and a copy shall be forwarded to
the National Administrative Register of the University of the Philippines Law Center.

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DR~~MA~DE IfDELA SERNA
.,- Interim/ OIC President and CEO

Date Signed: __ 'Yf_,_r'-+f--

SUBJECT IMPLEMENTATION OF AUTO-CREDIT PAYMENT SCHEME

(ACPS) TO ALL HEALTH CARE INSTITUTIONS

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ANNEXA:

HCI OFFICIAL LETTERHEAD

(Mailing Address, Email Address, PhilHealth Accreditation Number)

NOTICE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) COMPLIANCE FOR

PRIVATE HCis

Date

(Name of the PhilHealth Regional Vice-President)

(PhilHealth Regional Office Address)

Sir/Madame:

In compliance with the PhilHealth Auto-Credit Payment Scheme (ACPS) Policy, we are
hereby submitting the following bank account information:

1. Bank Name
- 2. Branch
3. Bank Account Name
4. Bank Account Number
5. Official HCI Email Address
6, Landline Number:
7. Mobile Number:

Further, we certify that the foregoing information are true and correct.
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Very truly yours,

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Page 1 of 1 of Annex A

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ANNEXB:
HCI OFFICIAL LETIERHEAD
(Mailing Address, Email Address, Phi!Health Accreditation Number)

NOTICE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) COMPLIANCE FOR

GOVERNMENT HCis

Date

(Name of the Phi!Health Regional Vice-President)

(Phi!Health Regional Office Address)

Sir/Madame:

In compliance with the Phi!Health Auto-Credit Payment Scheme (ACPS) Policy, we are hereby
submitting the following bank account information:

1. Bank Name
2. Branch
Bank Account Details
HCI Charges
Bank Account Name
3. Bank Account Number
Professional Fee Designated for Pooling
Bank Account Name
Bank Account Number
4. Official HCI Email Address
5. Landline Number
6. Mobile Number

Further, we certify that the foregoing information are true and correct.

r - - - - . . . ;'\~,r~IY truly yours,

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ANNEXC:
LGU OFFICIAL LETIERHEAD
(Mailing Address, Email Address)

NOTICE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) COMPLIANCE FOR

LGU OWEND HCis

Date

(Name of the Phi!Health Regional Vice-President)

(Phi!Health Regional Office Address)

Sir/Madame:

In compliance with the Phi!Health Auto-Credit Payment Scheme (ACPS) Policy, we are hereby
submitting the following bank account information:

1.BankName
2.Branch
Bank Account Details
HCI Charges
Bank Account Name
3. Bank Account Number
Professional Fee Designated for Pooling
Bank Account Name
Bank Account Number
4. Official HCI Email Address
5. Landline Number
;=:;= 6. Mobile Number
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Further, we certify that the foregoing information are true and correct.
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Very truly yours,

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ANNEXC
LGU OFFICIAL LETI'ERHEAD
(Mailing Address, Email Address)

NOTICE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) COMPLIANCE FOR

LGU OWEND HCis

Sir/Madame:

The listed HCis are under the LGUs jurisdiction, all Phi!H~alth
:..b-~~-·~:::;,fiit·,.p•ayrner'l•t of the listed
HCis shall be credited to the LGUs account. · . .._

Name
HCI

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Signed

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Page 2 of 2 of Annex C

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ANNEXD
SAMPLE BANK CERTIFICATE

~ BRANCH OPERATIONS MANUAL

~ Other Branch'Processes

BANK CERTIFICATION

BrMchNamc

CERTIFICATION
Th.h is to certify lhat.-~~=~~~-mni.nlllins deposit account with us un~er
Savings Account Numtier 3401-0944·90 with outstanding balance of PESOS:
___amount lo words (P_ _ __,
... r_(datc)c__ _ _ _.

nw. is to certify fw1her that the 11bovc c.ccount is free from lienS and encumbrances.
This infonnation is givat io strictest" confidence punuanl to Republic Act No. 1405.
The Bank or any ofiu officm is not ~ponsiblc for any unauthorized disclosure of s:cid
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infonnation.
1'his certi(icil.tion is Usued upon the written request of the obov~mentioncd client fur
whatever \egnl purpose it m:~y serve.

Authoriz;ed Sif::na\OQ'

Page : Exhibit 18.7.1

08te Flr.>t Prepared : Septembo::r 2013
oete Last Revised

Page 1 of 1 of Annex D

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ANNEXE:
HCI OFFICIAL LETTERHEAD
(Mailing Address, Email Address, Phi!Health Accreditation Number)

NOTICE OF CHANGE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) BANK

ACCOUNT FOR PRIVATE HCis

Date

(Name of the Phi!Health Regional Vice-President)

(Phi!Health Regional Office Address)

Sir/Madame:

May we respectfully request for updating of our bank account information for Phi!Health
Auto-Credit Payment Scheme (ACPS):

1. Bank Name
2. Branch
3. Bank Account Name
4. Bank Account Number
5. Official HCI Email Address
6. Landline Number:
7. Mobile Number:

Further, we certify that the foregoing information are true and correct.

Very truly yours,

(Signature over Printed Name of the Medical Director)

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Page 1 of 1 of Annex E

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ANNEXF:

HCI OFFICIAL LETTERHEAD

(Mailing Address, Email Address, Phi!Health Accreditation Number)

NOTICE OF CHANGE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) BANK

ACCOUNT FOR GOVERNMENT HCis

Date

(Name of the Phi!Health Regional Vice-President)

(Phi!Health Regional Office Address)

Sir/Madame:

May we respectfully request for updating of our bank account information for Phi!Health Auto-
Credit Payment Scheme (ACPS):

1. BankName
2. Branch
Bank Account Details
HCI Charges
Bank Account Name
3. Bank Account Number
Professional Fee Designated for Pooling
Bank Account Name

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Bank Account Number
4. Official HCI Email Address
5. Landline Number
6. Mobile Number

Further, we certify that the foregoing information are true and correct.

~ry truly yours,

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ANNEXG:

LGU OFFICIAL LEITERHEAD

(Mailing Address, Email Address)

NOTICE OF CHANGE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) BANK

ACCOUNT FOR LGU OWEND HCis

Date

(Name of the Phi!Health Regional Vice-President)

(Phi!Health Regional Office Address)

Sir/Madame:

May we respectfully request for updating of our bank account information for Phi!Health Auto-
Credit Payment Scheme (ACPS):

1. BankName
2. Branch
Bank Account Details
HCI Charges
Bank Account Name
3. Bank Account Number
Professional Fee Designated for Pooling
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Bank Account Number
4. Official HCI Email Address
- 5. Landline Number
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6. Mobile Number
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! Further, we certify that the foregoing information are true and correct.

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ANNEXG

LGU OFFICIAL LETIERHEAD

(Mailing Address, Email Address)

NOTICE OF CHANGE OF AUTO-CREDIT PAYMENT SCHEME (ACPS) BANK

ACCOUNT FOR LGU OWEND HCis

Sir/Madame:

The listed HCis are under the LGUs jurisdiction, all Phi!Health benefit payment of the listed
HCis shall be credited to the LGUs account.

HCIName Phi!Health Accreditation Number Address

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Signed

(Signature over Printed Local Chief Executive)

Page 2 of 2 of Annex G

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